How the Impact of Multiple Changes and Breakdowns in the Lives of Children and Young People in Care Affects Them and Their Relationships with Professional Carers

By Nancy Mohindra

Date Posted: Wednesday, 19 December 2007

In the following essay Nancy Mohindra, while reflecting on her own practice describes the unhappy childhood experiences of Angela, a young woman she looked after and supported. Nancy considers how a failure of Angela’s mother, her principal parenting figure, to offer her protection and consistent nurture together with a history of broken attachment relationships with substitute figures made it difficult for Angela – and those helping her – to achieve the emotional and social growth necessary to make her future prospects more hopeful. Nancy Mohindra has been living in the United Kingdom for four years. She graduated in psychology at Universidad Nacional de Colombia. She was working as a Clinical Psychologist with adults and young people in her homeland. Recently Nancy has worked with young people who are preparing to leave care She has successfully completed the Eagle House Graduate Diploma Course in Child Development and the Care of Children and Young People. This essay is revised from an essay which was first posted on the goodenoughlife blog in July 2006.

How the impact of multiple changes and breakdowns in the lives of children and young people in care affects them and their relationships with professional carers.

It should concern all of us involved with child care that we can become so inured to the poor life experiences of children in care that we seem to ignore the implications numerous breakdowns and changes in childhood have for the children we are charged with looking after. In this essay I reflect on this issue in relation to the children and young people who I help to look after. From this I begin to consider how children and young people from broken families might be better understood by foster parents, by residential institutions and by projects like the one I worked for which offered support to young people who were leaving care. To do this analysis I consider the narrative of a young person, Angela (who at the time I am writing about was preparing to leave care) through the light of a number of developmental theories but in particular attachment theory. I also consider how a young person’s disrupted life history impacts on the relationship between the young person and the caring adult. Finally I will draw some conclusions and make some suggestions for future practice. Angela is not the young person’s real name and I have changed particular details of her life story to protect her privacy.

The story of a childhood

When I met her, Angela was an 18 years old girl who lived a chaotic and unsafe lifestyle, which included using illegal drugs and drinking alcohol to excess. When I first worked with Angela she had recently been engaged in prostitution and had frequently been the victim of violent sexual assaults. How had all this come to be?
Angela was born into a family which could not protect her. At the age of two Angela was sexually abused. Since that time although she had intermittently spent periods of time living with her family, Angela had been in the care of her local authority. During her time in care her placements with different foster parents and in different children’s homes had invariably broken down. The principal reason given for these breakdowns was Angela’s unmanageable behaviour. When these breakdowns occurred, either Angela’s mother and other family members felt they could not cope with her behaviour, or her social worker felt Angela was not safe in her family. Throughout the period I worked with her Angela continued to be a very vulnerable young woman who placed herself at great risk. Her peer group was delinquent. She misused alcohol and other substances. Her lack of a consistent and emotionally stable family experience had meant that she had poor self-esteem and so inevitably she had adopted a negative attitude to what life might hold in store for her.
From 2004 to 2006 Angela had been moved six times from different care placements. She stayed at some of these for as little as three months. Some of the adults who had looked after Angela in these placements experienced her as a very difficult young woman and also Angela believed that in some of the children’s homes she had lived in she had chosen the wrong people to make friends with among the other residents. She thought they had have proved to be a negative influence on her. On the other hand Angela felt that in some of her placements she had fitted in very well but was made to move on to another place because her needs did not meet the criteria of the homes and families with whom she was placed. She felt that even when there were placements in which she fitted she was still required to move.
Since the end of 2005 Angela was supported by the leaving care project for which I work. Here Angela was provided with her own accommodation and with our outreach support she worked towards becoming able to live healthily and more independently in the wider community. There were however what seemed like overwhelming obstacles to achieving this goal. For instance on one occasion we had to move her from her apartment because she and her friends had been rowdily abusing Angela’s neighbours following a bout of excessive alcohol consumption.
Reflecting on incidents like these, it is possible to imagine why Angela had been rejected so many times. She could make those of us who offered her support fall in with her view that it will not possible for her to have a stable life. Probably for Angela, being uprooted all the time had come to seem the normal way of life. What we can infer from all this is that her emotional was fragile. It was as if an attachment to protective adult figures could not be accomplished since in Angela’s mind the feelings about her need for protection had been distorted.The consequences of poor attachment: an unhappy past, an unthinkable present and a blurred future

It seems to me that the person who should have been Angela’s most important parenting figure failed her. When her stepfather abused Angela, her mother did not protect her. It is my view that Angela’s mother, probably unconsciously, allowed her daughter to occupy her place in the relationship with her partner. Angela’s mother could not stop her partner’s abusive behaviour and possibly sacrificed her daughter in order to save her marriage. In this we can see a failure in the psychological structure of the family.

Ainsworth et al. (1978) as cited by Fonagy (2003:12) explains that there are two types of attachment.“Secure attachment implies representational systems where the attachment figure is seen as accessible and responsive when needed. Anxious attachment implies a representational system where the responsiveness of the caregiver is not assumed and the child adopts strategies for circumventing the perceived unresponsiveness of the attachment figure”.

We can see that Angela swung backwards and forwards between her family and her peer group. She was looking for love, protection, acceptance and belonging. Unconsciously, Angela knows that her family represent a broken attachment, yet she feels needs them. Her family, especially her mother, do not know how to approach Angela. For Angela’s mother, Angela represents her (the mother’s) failure and therefore the failure of her family system. It is Angela’s difficulty in recognizing the wound caused by her family which is in my view the principal element that kept Angela in her unhealthy style of living.

Angela suffered a cruel wound to her self esteem inflicted by those who should have been her nearest and dearest. In addition to this, Angela’s feelings of belonging to a family had been betrayed. What followed was that Angela became lost and detached in a very unhealthy world, where the bad people – for instance her abusing stepfather – got away with wrongdoing. Therefore Angela’s self-esteem and trust in life were lost. She was not able to accept that there might be a better future or indeed that she deserved a better world in which she could live with confidence.

What happens to people who work with young people like Angela

Professional carers who work with vulnerable children and young people, like Angela, experience a great number of painful emotions. Sometimes, as a mechanism of defence, staff will minimise or ignore all the problems and difficult circumstances of the young people. As a result of this there are occasions when it is easier “to pass the buck” than to admit that we are not prepared to face the avalanche of feelings which the young people are throwing at us. Carers who are alert to where these feelings may come from can begin to identify psychological mechanisms which stand in the way of the process of engaging with vulnerable young people.
Once we recognise those of our own defences which work towards us rejecting troubled young people, we are then in a better position to understand the inner world of these vulnerable people. Thus, in understanding our own feelings, which on many occasions will be stirred up by a disturbed young person, we are beginning to get in touch with what the feelings the young people are experiencing and we can become more able to hold the young people emotionally.

What happens between young people and their professional carers?

In order to understand further the exchange of feelings between young people and professional careers, Sharpe ( 2006) states:

“It is my experience that many of the young people who are placed in children’s homes cannot find the words, and so can’t always give meaning to their problems because they have recent and distant memories which are, for the time being, too painful to consider consciously”

If we accept this, then staff will be encountering a variety of feelings and emotions that the young people cannot name and in this frightening state young people will shout or scream instead of asking for help or they will withdraw instead of telling staff that they feel angry, sad, embarrassed or depressed.
At the same time, children and young people can distinctly recognise the feelings of insecurity coming from the staff. Menzies Lyth (1989) as cited by Sharpe (2001:33) points out this aspect when she says “insecure staff will make insecure children feel even more insecure, more anxious and inevitably, less predictable”.
As Barbara Dockar Drysdale (1959, cited by Sharpe, 2001:6) suggests “only if staff are aware of the dynamics of the inner world of each of the children” will they be able to provide a healthy resource to them which will allow them to be reconciled with the world of the adults.

In my own work I have experienced those feelings of despair, powerlessness, insecurity, anger and many other feelings. I have felt the fear and disapproval coming from the young person through my counter-transference. I have found myself disapproving of the way young people live and relate to others. I have sometimes forgotten that my role is to give support and care. At the same time I tried to remember that the reason why those young people were placed in the care of the project for which I worked was because their sense of reality had become distorted. This probably did not make them psychotic (as my counter-transference could sometimes make me feel) but it had engendered in them anti-social and self-harming behaviour.

What sort of feelings might we find among professional carers working with young people in need?

Human beings are highly complex and so are their coping mechanisms. As Jean Moore (1992) suggests the feelings of the people working with children and young people who are at risk are ambivalent. It is possible to come across feelings both of omnipotence and impotence. These feelings are two sides of the same coin. In the case of omnipotence, the worker wants to be sure that the child or young person who is under her care will be safe and away from any danger. Yet it is impossible to control all the variables of the child’s life. Most important, it is not healthy to rule somebody else’s life to the point that we interfere with their choices, even though these choices can be wrong. On the other side of the coin, we sometimes feel incapable of achieving any change in their lives. We are faced with feelings of impotence. On many occasions, carers are overwhelmed by the noxious circumstances of the young person’s family life, or feel powerless in the face of what they experience as a lack of support from their colleagues or other agencies. The worker will discover herself struggling between feelings of anger or/and guilt. These feelings are in close relationship with the feelings described above. For example, if I feel as if I have done everything possible to alleviate Angela’s pain, why is she not responding? Here I stumble on the feelings of anger. The anger could be the result of my own feelings of impotence. In my mind I may have had an omnipotent fantasy of control over the young person’s life, seeing the young person as a passive object of their support. I may direct my anger at the young person’s failure to respond to my help when in fact I am in denial of my own failure. What I have forgotten here is that the young person responds with his own psychological resources to what the life has to offer to him and not mine. Even in that disordered way of thinking where to Angela her abusive friends seemed better than none, I needed to try to hold on to the idea that it was not my responsibility to restrain Angela’s choices but to help her reflect on them. In the same way, my own feelings of guilt came to the surface when I was faced with circumstances that were beyond everybody’s control or after realising that my intervention was not “good enough”, either because I was “tired” or too involved with Angela. For instance, I might have said to myself “I should have been assertive and stopped Angela fighting with her neighbours before it became too late”.

Finally there are two other circumstances encumber the professional carer. One is when she has a feeling of depression and another is when she begins to feel accusatory. Moore (1992) offers a very good model of those feelings when she considers the carer placed in what she calls ‘a non-solution case’. Moore explains that in many cases the difficulty appears when a well-known case blows up, like Angela’s hits a crisis. All of us, my colleagues in my team, and the social worker knew about her case knew case, but even though these many colleagues had been trying to implement changes, nobody has been able to succeed and get any positive outcome. For instance, because we could not be present with Angela all the time she was influenced by her friends to indulge in a drinking binge. This situation made her very vulnerable and indeed led her to being moved from her apartment. Moore argues that worker who has special responsibility for the young person, in this case me, can be so overwhelmed by feelings of deep failure and imagined persecution that she will tend to isolate herself from her colleagues and the young person Alternatively, Moore suggests the carers reaction can be one of accusing or blaming. The carer blames the lack of resources, government policies, the lack of support from others agencies and so on. In my work with Angela I have run through at one time or another all the feelings I have described here.

Recommendations

In reflecting on what I have written I believe it is important to acknowledge the necessity of good supervision for staff who face a large number of demands both from other agencies and from the young people who are in their care. Support given to staff will reduce their emotional fatigue and does in my view increase their feelings of personal accomplishment.

In my work with Angela I have become increasingly aware of the need for careers who work with emotionally troubled young people to be provided with ongoing training in such areas as child development, group dynamics, the primary care needs of children and young people and most importantly, how careers and young people engage with each other.

In conclusion, I believe that when we face a child or young person who has been placed into care, we ought to be aware of his life narrative, the reasons for his admission into care, the number of times he has been placed in care settings, the kind of care settings he has been placed in. In this way we can begin to get in touch with how the young person feels but also if we have been properly trained we will be in touch how he makes us feel and be in a position to engage in a caring relationship with him in which a compensatory kind of therapeutic attachment can take place.